MEDICARE: MRS. ROSANA PATRICIA MAUMUS MA 55164

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA 55164	FL

General Provider Information

NPI Number	:	1750516167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROSANA PATRICIA MAUMUS MA 55164

Provider Business Mailing Address
First Line	:	215 SW 30TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-2716
Country	:	US
Telephone Number	:	786-355-2468
Fax Number	:	305-643-0896

Provider Business Practice Location Address
First Line	:	1450 CORAL WAY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-2856
Country	:	US
Telephone Number	:	305-446-7250
Fax Number	:	305-446-7260

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2009
Last Update Date	:	05/29/2009

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